CO Toxicity

In support of Gov. Maggie Hassan’s recently signed proclamation naming November as Carbon Monoxide Awareness Month, it is appropriate to share the importance of this timely public health message in my first NHMS blog. 

Many years ago as an undergraduate student at UNH, I volunteered as an EMT for a newly installed hyperbaric oxygen chamber.   A donation from a New York university, the chamber was unusually large in comparison to other chambers and could contain four adults and a patient during a treatment.  I recall some of the distinct differences to the patients, really challenging cases, we treated in the chamber to those I have treated in emergency departments in large inner cities and communities as well.  The one striking commonality is not the severity of any given patient nor the tragedy for those who did not wake up or fully recover from an acute high concentrated exposure, but rather those who had presented after sustained, lower concentration exposures.

Cigarette Tax - Call Your Senator Today!

As you may recall, increasing the New Hampshire tobacco tax has been a key legislative priority for NHMS this session.  Governor Hassan and the New Hampshire House included an important $0.30/pack increase in the state budget bill.  With this level of increase we can expect 4,000 adults to quit; even more children will not start smoking in the first place; $24 million in new money will support the state budget; and the state will realize $1 million in direct health care savings.

 

Choice of Physician or Network?

My last two posts dealt with the new Health Insurance Exchange, or “Marketplace,” which opened yesterday, and I talked about some of the concerns with the limited options and a limited provider network. What will be the impact for 2014 for our patients and costs? I heard from several of you with your ideas and concerns and thought I would share them with you today.

 

Violence and Public Health

This year I have written several times about violence and its impact on the public’s health, and last week I shared our N.H. physician survey results indicating that addressing gun violence was a priority for many of you.

Carpe Diem

As many of us reflect on the recent death of Robin Williams, the gifted comedian, actor, husband and father of three, much of the focus in the media this week has been on the issues of depression, substance abuse, addiction and suicide.  It was refreshing to hear some of the commentators talk about depression as a “brain disease” and not use the term “mental illness” as much as might be expected.

Can't always sort wheat from chaff

In follow up to last week’s blog, it may be considered somewhat reflexive to speak to a confounding circumstance in the recognition and treatment of multi-substance abuse and addiction.  Mental illness is intertwined in the management of substance abuse and addiction.  Neither one of these complex conditions are adequately addressed through episodic care, whether it is rendered in an emergency department, a primary care office or from a three-day stay in a psychiatric facility.  Rarely are any of the underpinnings addressed adequately, and quite often the process can be viewed as simply inhumane.

Violence as a Public Health Issue

The violent events of the past year and my writing about them here have provoked strong feelings among our members and raised, I think, good questions like: What can I do as a physician to impact this problem? Do I even have a role?  The problem seems so big that it is very difficult for us to get our hands around.  Are there only policy solutions? Are there clinical solutions?  Are there community solutions? Or, is this just the way things are and we should accept them? 

We asked, you spoke!

"We live on an island surrounded by a sea of ignorance. As our island of knowledge grows, so does the shore of our ignorance." - John Archibald Wheeler, eminent American theoretical physicist

Earlier this year, NHMS conducted a survey to learn more about you, what is important to you, and what you think should be priorities for NHMS. We had a great response and learned the following:

We Have the Technology

On March 7, 1973, when I was 9 years old, the medical future came into my living room in Brooklyn, N.Y., via a 25-inch Zenith color television.  On that night, Steve Austin, a civilian astronaut, crashed in a test flight accident and lost his right arm, left eye and both legs.  Luckily for Colonel Austin, a Vietnam veteran who had walked on the moon, he was able to be “rebuilt” with artificial legs that allowed him to run at 60 mph, a prosthetic arm that could lift 150 pounds (and had a Geiger counter for radiation detection) and a bionic eye, complete with a 20:1 zoom lens and infrared capabilities, thanks to the generosity of the American Broadcasting Company.  Total cost?  6 million dollars.

Bullying in Health Care

Over the past few weeks, a sports story has grabbed national attention because of its implication for workplace bullying issues.  This case involves the Miami Dolphins of the National Football League, and the main players involved are Richie Incognito (the alleged bully) and Jonathan Martin (the alleged victim).

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